Why is she choosing a Cesarean?

This post is NOT about medically necessary cesareans, there are certainly times when choosing a cesarean is obviously the best choice, when the life of mom or baby is at stake. This is also is a total of 4 posts that go together, scroll down my blog for the rest!

It is sometimes frustrating to see moms choose to schedule a cesarean without what we (people who trust birth) see as a true medical need. It is easy to blame the moms, why don’t they know better?

Well, I think the problem is not with the moms, it is with the birthing community leading them to that choice in many different ways… The moms are often scared into a cesarean or don’t realize they have other options.

Here are some ways moms are led to cesareans before their birthing time even begins.

Some are gently led there, by little lies given along the way by their care providers. The big baby card is a prevalent way care providers do this today. (Your baby looks like it is going to be big… your pelvis is small… this baby is too big for you to birth, you had better have a cesarean)

Some are scared into it, VBAC moms are told it isn’t safe, or they can never have a vaginal birth, it didn’t work last time, it won’t this time either.

Some are told vaginal birth isn’t even an option… your baby is breech; you HAVE to have a cesarean. Moms don’t even know they have a choice, they can try to turn the baby or they can find a care provider who supports vaginal breech birth. (It is hard to find these care providers, because many are not being trained to do so.)

Twin moms are also often talked into cesareans. I am not so familiar with the reasons they are given for this, but I know that many moms with twins assume they have to have a cesarean. So if you know some of the reasoning, feel free to add to my comments.

Just to say I was one of “those moms” recently dealing with a doctor who wanted to schedule me for a 39 week c-section when the baby was still breech at 36 weeks. After he did an internal exam, he said the baby’s butt was right on top of my cervix. When I asked about the possibility of the baby turning, he said the child was too far “tucked down in” there to move, and at this point I “could stand on my head, but the baby wasn’t going anywhere.” He would not discuss the possibility of a vaginal birth, saying that the head is the biggest part so if s/he got stuck after the rest of the body was through, we would “lose big” on our gamble for a birth (guilt trip). Moreover, when I wanted to hold off scheduling the section, he said, “Ok, but the longer you wait all that happens is that you have fewer choices on dates and times.”

My husband was no help – on a trip to Europe at the time, and as he was delivered by c-section, he sees the procedure as helpful and necessary. I think sometimes, it’s not just the fear of the mothers, but of the fathers that takes over. I trust my body far more than my husband does.

Fortunately, when I was crying about this experience to a friend, she mentioned that one of her good friends is a midwife, and called her for me. The midwife’s advice – find out who in the practice does ECV, and if no one does, get a referral to a maternal-fetal medical specialist who does. My sister-in-law in another state reached out to her doula on my behalf, and got similar advice back to me. So I called back, rescheduled my next appointment with another doctor who, it turns out, was receptive to both trying to turn the baby and, though not his preference, a vaginal breech birth. He encouraged me to also try alternative methods to turn the baby, too. Well, through another friend, I found a chiropractor who does Webster and is also an acupuncturist. Though these visits didn’t result in turning the baby, I think they loosened me up to where my body was more receptive to the ECV which was successful when the new doctor tried it two days ago.

I’m now 38 weeks and looking forward to a normal birth, but the key was networking. I felt totally helpless with the first doctor, but other women helped validate my need to look for alternatives. I think I hit the jackpot with my new doctor, but even if I hadn’t, I was armed with enough knowledge to ask the right questions and to find someone willing to try to turn the baby.

In answer to your original questions – help individual mothers know it’s okay to ask questions and not settle for one doctor’s opinion. It helped me to hear the same options given by several people both within and outside of the ‘medical establishment’. If an individual mother isn’t listening, it might be because she hasn’t heard what she needs to hear from the “right” person; doctors can be very persuasive, and if the first doctor hadn’t been so abrasive that I ran in the other direction, I might have scheduled that c-section. To change the medical establishment, you’ve also got to change the legal system; too many doctors don’t do “risky” births because they are scared of being sued – and with malpractice insurance what it is today, I can’t say I blame them. That said, my doctor who referred to vaginal breech birth as “a dying art”, said that it’s foolish not to train doctors in the procedure because sometimes you have no choice – a woman could come in at the last minute fully dilated and in the process of giving birth to a breech baby and the doctor HAS to respond. More doctors need to be well trained in the procedure; it was really luck that I found a doctor who can (and would) do it. I’m also glad that he proved skillful enough to turn the baby of a first time mom at 38 weeks, and I don’t need to make the c-section decision now.

C-section has been mentioned to me because I’m being watched for pre-eclampsia. Sometimes it feels like I’m not “supposed to” get a c-section and there’s a lot of fear mongering about “major abdominal surgery” *cue the DUN DUN DUUUUNN!* but when it is necessary, it is necessary.